Publication:
Oral saliva swab reverse transcription PCR for Covid-19 in the paediatric population.

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Date

2022-06-10

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Moraleda, Cinta
Domínguez-Rodríguez, Sara
Mesa, Juan Miguel
García-Sánchez, Paula
de la Serna, María
Alonso-Cadenas, José Antonio
Bermejo, Amanda
Sabrido, Gema
Martínez-Campos, Leticia
González-Posada, Aránzazu Flavia

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Abstract

To evaluate the performance of oral saliva swab (OSS) reverse transcription PCR (RT-PCR) compared with RT-PCR and antigen rapid diagnostic test (Ag-RDT) on nasopharyngeal swabs (NPS) for SARS-CoV-2 in children. Cross-sectional multicentre diagnostic study. Study nested in a prospective, observational cohort (EPICO-AEP) performed between February and March 2021 including 10 hospitals in Spain. Children from 0 to 18 years with symptoms compatible with Covid-19 of ≤5 days of duration were included. Two NPS samples (Ag-RDT and RT-PCR) and one OSS sample for RT-PCR were collected. Performance of Ag-RDT and RT-PCR on NPS and RT-PCR on OSS sample for SARS-CoV-2. 1174 children were included, aged 3.8 years (IQR 1.7-9.0); 73/1174 (6.2%) patients tested positive by at least one of the techniques. Sensitivity and specificity of OSS RT-PCR were 72.1% (95% CI 59.7 to 81.9) and 99.6% (95% CI 99 to 99.9), respectively, versus 61.8% (95% CI 49.1 to 73) and 99.9% (95% CI 99.4 to 100) for the Ag-RDT. Kappa index was 0.79 (95% CI 0.72 to 0.88) for OSS RT-PCR and 0.74 (95% CI 0.65 to 0.84) for Ag-RDT versus NPS RT-PCR. RT-PCR on the OSS sample is an accurate option for SARS-CoV-2 testing in children. A less intrusive technique for younger patients, who usually are tested frequently, might increase the number of patients tested.

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Child
Humans
COVID-19
SARS-CoV-2
COVID-19 Testing
Saliva
Reverse Transcription
Prospective Studies
Cross-Sectional Studies
Sensitivity and Specificity
Polymerase Chain Reaction

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Keywords

Covid-19, Infectious Disease Medicine, Microbiology, Molecular Biology, Virology

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